title: AANA Journal Course: update for nurse anesthetists--management of malignant ventricular tachyarrhythmias: the role of drug therapy and surgical intervention in sudden cardiac death survivors.
abstract: The use of implantable cardioverter-defibrillators (ICDs) to treat patients with ventricular tachyarrhythmias and sudden cardiac death (SCD) has increased over the last decade. Once applied as therapy of last resort, new surgical techniques and improved technology have made the procedure relatively noninvasive. As a result, it is becoming increasingly more common for patients to undergo insertion of this life-saving device in nonoperating room locations. Because patients who require insertion of ICDs often have significant underlying cardiac disease, developing a plan of anesthesia management tailored to meet their needs and predispositions may be a challenge. This Journal Course reviews, from an historical as well as contemporary perspective, the medical and surgical management of patients with ventricular tachyarrhythmias at risk to sustain SCD. A case presentation format is utilized to illustrate an example of an anesthetic plan of care for a patient who underwent insertion of an ICD. Additional information is presented regarding the impact of the ICD on quality of life and overall healthcare costs. As our healthcare system continues to change and evolve, when treatment options are considered, quality of life and cost issues are becoming increasingly more important.
authors.affiliation: Department of Anesthesiology, Albany Medical College, New York, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Van Wormer
authors.forename: D
authors.initials: D
authors.lastname: Martin-Sheridan
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D017147:Defibrillators, Implantable; D004509:Education, Nursing, Continuing; D006801:Humans; D008297:Male; D009719:Nurse Anesthetists; D017741:Survivors; D017180:Tachycardia, Ventricular / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*
chemical_list: D000889:Anti-Arrhythmia Agents